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Why health reform is so unpopular

06/21/12 09:29 AMUpdated 08/07/13 08:15 AM

Why health reform is so unpopular

Associated Press

If we put aside everything we know about the politics of the last three years and consider the debate over health care policy in the abstract, “Obamacare” should be the most popular thing in the country. That may seem absurd, but hear me out.

For 100 years, national leaders have been trying to get health care reform done, and for 100 years, officials in both parties have come up short. As the system grew more dysfunctional, costing too much and covering too few, public demand for reform intensified. It served as a driving issue in many campaigns, including presidential races.

In 2009 and 2010, President Obama helped oversee a slow, deliberate process, with outreach to both parties, which led to a comprehensive law filled with popular ideas, many of which have enjoyed bipartisan support for decades. After a century of trying, Obama finally made reform a reality, and millions are already benefiting. It was, as Vice President Biden put it, a big bleeping deal.

And yet, most Americans, even those who gain the most from the Affordable Care Act, hate it.

How can this be? While we wait for the Supreme Court’s decision on the law’s fate – a ruling could come within the hour – there are two broad angles to consider. The first is that well-financed misinformation campaigns work.

[The success of the law’s opponents] may stem in large part from more than $200 million in advertising spending by an array of conservative groups, from the U.S. Chamber of Commerce ($27 million) to Karl Rove’s Crossroads GPS ($18 million), which includes the billionaire Sheldon Adelson among its donors, and the American Action Network ($9 million), founded by Fred V. Malek, an investor and prominent Republican fund-raiser.

In all, about $235 million has been spent on ads attacking the law since its passage in March 2010, according to a recent survey by Kantar Media’s Campaign Media Analysis Group. Only $69 million has been spent on advertising supporting it.

Millions of Americans, especially in key battleground states, have turned against the law because they’ve been told to hate it. Voters have heard so many negative claims about “Obamacare” so often, they’ve started to believe them – even though the claims aren’t true. $235 million, in other words, can change a lot of minds, and convince people who want and need health care reform to reject a law that would serve them well. The right relies on well-financed propaganda campaigns because well-financed propaganda campaigns work.

An analysis by PEJ of the language used in the media (PEJ research) reveals that opponents of the reform won the so-called “messaging war” in the coverage. Terms that were closely associated with opposition arguments, such as “government run,” were far more present in media reports than terms associated with arguments supporting the bill, such as “pre-existing conditions.”

To conduct the analysis, researchers examined and identified three of the most common concepts being pushed by opponents of the bill and the three concepts being promoted by supporters and then examined the news coverage for the presence of those concepts and language. The concepts used by opponents were nearly twice as common as those used by supporters.

It’s a recipe for a distasteful cocktail. Take a quarter of a billion dollars in far-right advertising, throw in media reports that internalize Republican frames while focusing on politics over policy, and add a pinch of scared congressional Democrats who are afraid of losing, and the result is widespread confusion, ignorance, and opposition to measures the American mainstream has been demanding for years.